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Multiple personalitiesFrom: Betsy Hyde (elishyde@connix.com)Tue Feb 8 17:12:50 2000
This is *not* a joke question. We have a pregnant patient with depression. Oddly, though, some of us thought she was *seriously* depressed and suicidal (has a plan...insulin overdose as soon as the baby is born), while others thought she was just fine....and that the rest of us were just plain old over-reacting, or poor judges of psychiatric conditions. Two of us did the good cop-bad cop routine with her husband present, and were able to get her admitted once due to suicide threats, and it turns out (after contact with her out-of-state therapist) that she has multiple personality disorder (not called that these days, but I forget the real DSM term). She signed out AMA as soon as the mandatory hold had expired. Unfortunately, the only psych bed was on a detox unit, and she found it exceedingly scary and unpleasant. Psych was *not* at all helpful. Has anyone cared for a woman with multiple personalities? If one of the personalities is suicidal, but another personality is fine, and there seems to be no rhyme or reason as to which personality appears on a given day, what do we do? What is the legal/moral/ethical responsibility for caring for someone who sometimes is suicidal yet refuses admission, and sometimes is fine? (She tends to call and say that she feels really depressed, and is afraid she'll kill herself before the baby is born, yet refuses hospitalization. Her partner won't bring her in.) And how do we handle the differing personae?
-- Betsy Hyde CNM
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